Black Youth Helpline: Volunteer Application Form

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National Helpline for Canadian Youth and Families

Bridging Cultures...Reaching Youth.....Impacting Change. Our 3 main values are Respect, Education, and Health.

References will be required prior to direct involvement working with youth. Otherwise, you are able to commence general volunteer involvement upon completion of the volunteer application process.

Applicant’s Name *

Age *

City *

Province *

Telephone

Email Address

Your country of origin (supports cultural knowledge exchange) *

Language Proficiency (e.g. French, English, etc.) *

How did you learn about the Black Youth Helpline? *

Why do you want to volunteer? *

Occupation/ Profession

School/University or College & Program of Study

If studying, please indicate school grade or program year

Indicate area(s) that you would like to contribute *

Describe any other special skills, strengths and interests you bring *

Indicate specific availability *

Any other comments

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